宫腔镜子宫内粘连松解术联合雌二醇片/雌二醇地屈孕酮片对宫腔粘连患者子宫内膜修复及妊娠结局的影响

Effect of Hysteroscopic Intrauterine Adhesiolysis Combined with Estradiol Tablets/Estradiol Didroxyprogesterone Tablets on Endometrial Repair and Pregnancy Outcome in Patients with Intrauterine Adhesions

目的探讨宫腔镜子宫内粘连松解术联合雌二醇片/雌二醇地屈孕酮片在宫腔粘连患者中的应用价值.方法选择2020年7月—2021年7月本院收治的宫腔粘连患者60例,按随机数字表法分为两组,每组30例.两组均行宫腔镜子宫内粘连松解术,对照组术后采用戊酸雌二醇治疗,观察组术后采用雌二醇片/雌二醇地屈孕酮片治疗,两组均治疗3个月并随访12个月.比较两组的子宫内膜修复情况、子宫内膜厚度(双层)、月经量、妊娠结局及不良反应发生情况.结果治疗后,观察组的子宫内膜修复情况优于对照组,差异有统计学意义(P<0.05).治疗后,观察组的子宫内膜厚度为(8.96±0.84)mm,厚于对照组的(7.93±0.75)mm,月经量评分为(67.93±5.73)分,高于对照组的(52.27±4.01)分,组间差异有统计学意义(P<0.05).随访12个月,观察组的临床妊娠率为66.67%,高于对照组的36.67%,差异有统计学意义(P<0.05).两组的不良反应发生率比较,差异无统计学意义(P>0.05).结论宫腔镜子宫内粘连松解术联合雌二醇片/雌二醇地屈孕酮片能有效促进宫腔粘连患者子宫内膜修复,增加其子宫内膜厚度,改善月经量,提高妊娠率,安全可行,值得临床推广使用.

Objective To investigate the application value of hysteroscopic intrauterine adhesiolysis combined with estradiol tablets/estradiol didroxyprogesterone tablets in patients with intrauterine adhesions.Methods 60 patients with intrauterine adhesions admitted to the hospital from July 2020 to July 2021 were selected and were divided into two groups according to random number table method,with 30 patients in each group.Both groups received hysteroscopic intrauterine adhesiolysis.The control group was treated with estradiol valerate after surgery,and the observation group was treated with estradiol tablets/didroxyprogesterone tablets after surgery.Both groups were treated for 3 months and followed up for 12 months.The endometrial repair,endometrial thickness(double layer),menstrual volume,pregnancy outcome and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the endometrial repair in the observation group was better than that in the control group,the difference was statistically significant(P<0.05).After treatment,the endometrial thickness in the observation group was(8.96±0.84)mm,which was thicker than(7.93±0.75)mm in the control group,and the menstrual volume score was(67.93±5.73)points,which was higher than(52.27±4.01)points in the control group,and the differences between the groups were statistically significant(P<0.05).After 12 months of follow-up,the clinical pregnancy rate in the observation group was 66.67%,higher than 36.67%in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Hysteroscopic intrauterine adhesiolysis combined with estradiol tablets/didroxyprogesterone tablets can effectively promote endometrial repair in patients with intrauterine adhesions,increase endometrial thickness,menstrual volume,and pregnancy rate.It is safe and feasible,worthy of clinical promotion.